Complementary Feeding Practices in Mexico Vary According to Medical Experience and Family History of Atopy

Bedolla-Pulido, Tonatiuh Ramses; Meza-López, Carlos; Morales-Romero, Jaime; Herrick-Ramos, Christopher William; Aguirre-Sahagún, Andrea Samari; Bedolla-Barajas, Martín

doi:10.22038/jpp.2026.94294.5626

Complementary Feeding Practices in Mexico Vary According to Medical Experience and Family History of Atopy

Document Type : original article

Authors

Tonatiuh Ramses Bedolla-Pulido ¹

Carlos Meza-López ¹

Jaime Morales-Romero ²

Christopher William Herrick-Ramos ³

Andrea Samari Aguirre-Sahagún ¹

Martín Bedolla-Barajas ⁴

¹ Servicio de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Guadalajara, México.

² Instituto de Salud Pública, Universidad Veracruzana. Xalapa, México.

³ Servicio de Pediatría, Hospital Civil de Guadalajara Fray Antonio Alcalde. Guadalajara, México.

⁴ Servicio de Alergia e Inmunología Clínica, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Guadalajara, México.

10.22038/jpp.2026.94294.5626

Abstract

Background: Complementary feeding (CF) practices continue to be a topic of debate .This study aims to analyze pediatricians' CF practices for infants in Mexico based on their years of experience and family history of atopy.
Methods: Members of a pediatrics association completed an online survey regarding CF practices. Pediatricians were divided into two groups based on their years of medical practice (<10 and ≥10 years). Simple and multivariate correspondence analyses were conducted.
Results: A total of 133 pediatricians participated, with 60% being women, a mean age of 48.3 years, and an average medical practice experience of 19.8 years. The recommended first food for infants varied based on years of pediatric practice: "meat" or "no preference" (0–10 years), "fruits" (21–30 years), and "vegetables" (≥21 years) (p = 0.017). In terms of who should decide the order of food introduction responses were "the family" (0–10 years) or "the pediatrician" (≥21 years) (p = 0.004). Pediatricians in public healthcare primarily recommended introducing one new food every two days (p = 0.007). Multivariate analyses revealed that having ≥ 10 years of experience was positively associated with recommending fruits as the first food to introduce (OR = 3.5, 95% CI: 1.56–7.93, p = 0.002) and negatively associated with recommending meat as the first food (OR = 0.26, p = 0.014).

Keywords

Complementary feeding

Infant

Pediatrics

Weaning

Lutter CK, Grummer-Strawn L, Rogers L. Complementary feeding of infants and young children 6 to 23 months of age. Nutrition reviews. 2021 Aug 1;79(8):825-46.
World Health Organization. WHO Guideline for complementary feeding of infants and young children 6–23 months of age. Geneva: World Health Organization; 2023. Google Scholar. 2024:1.
Koplin JJ, Osborne NJ, Wake M, Martin PE, Gurrin LC, Robinson MN, et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. Journal of Allergy and Clinical Immunology. 2010 Oct 1;126(4):807-13. 4. Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. New England Journal of Medicine. 2015 Feb 26;372(9):803-13.
Tan JW, Valerio C, Barnes EH, Turner PJ, Van Asperen PA, Kakakios AM, et al. A randomized trial of egg introduction from 4 months of age in infants at risk for egg allergy. Journal of Allergy and Clinical Immunology. 2017 May 1;139(5):1621-8.
Sakihara T, Otsuji K, Arakaki Y, Hamada K, Sugiura S, Ito K. Randomized trial of early infant formula introduction to prevent cow’s milk allergy. Journal of Allergy and Clinical Immunology. 2021 Jan 1;147(1):224-32.
Österlund J, Granåsen G, Bodén S, Silfverdal SA, Domellöf M, Winberg A, et al. Revised Swedish infant feeding guidelines are associated with earlier introduction of allergenic foods. Journal of Allergy and Clinical Immunology. 2024 Feb 1;153(2):461-70.
Caroli M, Vania A, Verga MC, Di Mauro G, Bergamini M, Cuomo B, et al. Recommendations on complementary feeding as a tool for prevention of non-communicable diseases (NCDs)—Paper co-drafted by the SIPPS, FIMP, SIDOHaD, and SINUPE joint working group. Nutrients. 2022 Jan 7;14(2):257.
Sirkka O, Abrahamse-Berkeveld M, van der Beek EM. Complementary feeding practices among young children in China, India, and Indonesia: a narrative review. Current developments in nutrition. 2022 Jun 1;6(6):nzac092.
Ladino L, Vázquez-Frias R, Montealegre L, Bagés-Mesa MC, Ochoa-Ortiz E, Medina-Bravo PG. E-1500: Survey on feeding practices in the first 1,500 days of life, recommended by healthcare professionals in Latin America. Revista de Gastroenterología de México (English Edition). 2022 Oct 1;87(4):439-46.
Ortega-Cisneros CM, Vidaña-Pérez D, Basto-Abreu A, Iglesias-Leboreiro J, Venegas-Andrade A, Rodriguez-Santaolaya P, et al. Complementary feeding practices in Mexican healthy infants: How close are they to the current guidelines?. Boletín médico del Hospital Infantil de México. 2019 Dec;76(6):265-72.
Samady W, Campbell E, Aktas ON, Jiang J, Bozen A, Fierstein JL, et al. Recommendations on complementary food introduction among pediatric practitioners. JAMA network open. 2020 Aug 17;3(8):e2013070.
Du Toit G, Huffaker MF, Radulovic S, Feeney M, Fisher HR, Byron M, et al. Follow-up to adolescence after early peanut introduction for allergy prevention. NEJM evidence. 2024 May 28;3(6):EVIDoa2300311.
Burgess JA, Dharmage SC, Allen K, Koplin J, Garcia‐Larsen V, Boyle R, et al. Age at introduction to complementary solid food and food allergy and sensitization: a systematic review and meta‐analysis. Clinical & Experimental Allergy. 2019 Jun;49(6):754-69.
Romero-Velarde E, Villalpando-Carrión S, Pérez-Lizaur AB, Iracheta-Gerez M, Alonso-Rivera CG, López-Navarrete GE, et al. Consenso para las prácticas de alimentación complementaria en lactantes sanos. Boletín médico del hospital infantil de México. 2016 Oct;73(5):338-56.
European Society for Paediatric Gastroenterology, Hepatology & Nutrition (ESPGHAN), Fewtrell M, Baumann U, Bronsky J, Haiden N, et al. World Health Organization (WHO) guideline on the complementary feeding of infants and young children aged 6− 23 months 2023: A multisociety response. Journal of Pediatric Gastroenterology and Nutrition. 2024 Jul;79(1):181-8.